Lugada Eric, Ochola Irene, Kirunda Anthony, Sembatya Moses, Mwebaze Sheila, Olowo Martin, Ladwar Denis Okidi, Komakech Henry
USAID/Strengthening Supply Chain Systems Activity, Uganda, Management Sciences for Health, Plot 15, Princess Anne Drive, Bugolobi, P. O. Box 71419, Kampala, Uganda.
J Pharm Policy Pract. 2022 Oct 5;15(1):58. doi: 10.1186/s40545-022-00452-w.
Health supply chain systems are essential for effective and efficient healthcare system by ensuring availability of quality essential medicines and health supplies. While several interventions have been made to ensure the availability of quality essential medicines and health supplies, health facilities continue to report stockouts in Uganda.
This study aimed to assess the status and performance of the supply chain system across all levels of care in health facilities in Uganda.
This was a cross-sectional study conducted in 128 public and private-not-for-profit health facilities across 48 districts in Uganda. These facilities included all levels of care from Health Centres II, III, IV, general and referral hospitals, and national referral hospitals. Data were collected using desk reviews, health facility surveys, and key informant interviews with key personnel. Stock registers were reviewed to assess the availability of a basket of essential medicines based on the essential medicines list of the Ministry of Health.
Less than half (42%) of health facilities had computer hardware. Most (84%) of health facilities were using a form of Logistics Management Information System with only (6%) were using the Electronic Logistics Management Information System. Just under a third (33%) of health information officers and (51%) of public health officers' positions were filled in the health facilities. Nearly (66%) of health facilities used supply chain data to support decision-making. Most (84%) of health facilities reported stockouts of Essential Medicines and Health Supplies in the past 6 months. The main reasons for stockouts were (59%) a sudden increase in demand (40%) delivery gaps/delayed deliveries and (35%) discrepancies in orders and deliveries. Health facilities responded to stockouts through various means including (75%) redistribution (43%) purchased from a distributor, and (30%) placing emergency orders.
The findings from this study show that the performance of health facilities in different supply chain processes and functions was defective. To improve the supply chain performance of health facilities, it is important to invest in infrastructure development, provide computer hardware and internet connection and strengthen the capacity key personnel. This is key for ensuring full functionality of the supply chain and availability of quality medicines and health supplies to the end-user.
卫生供应链系统对于有效且高效的医疗体系至关重要，它能确保优质基本药物和卫生用品的供应。尽管已采取多项干预措施来确保优质基本药物和卫生用品的供应，但乌干达的医疗机构仍不断报告药品短缺情况。
本研究旨在评估乌干达医疗机构各级护理中供应链系统的现状和绩效。
这是一项横断面研究，在乌干达48个地区的128家公立和私立非营利性医疗机构中开展。这些机构包括从二级、三级、四级卫生中心、综合医院和转诊医院到国家转诊医院的各级护理机构。通过案头审查、医疗机构调查以及与关键人员的关键信息提供者访谈来收集数据。审查库存登记册，以根据卫生部的基本药物清单评估一系列基本药物的供应情况。
不到一半（42%）的医疗机构拥有计算机硬件。大多数（84%）医疗机构使用某种形式的物流管理信息系统，只有6%使用电子物流管理信息系统。医疗机构中近三分之一（33%）的卫生信息官员职位和51%的公共卫生官员职位空缺。近66%的医疗机构使用供应链数据来支持决策。大多数（84%）医疗机构报告在过去6个月中出现基本药物和卫生用品短缺情况。短缺的主要原因是需求突然增加（59%）、交付差距/交付延迟（40%）以及订单与交付之间的差异（35%）。医疗机构通过多种方式应对短缺，包括重新分配（75%）、从经销商处购买（43%）以及下达紧急订单（30%）。
本研究结果表明，不同供应链流程和功能中的医疗机构绩效存在缺陷。为提高医疗机构的供应链绩效，投资基础设施建设、提供计算机硬件和互联网连接并加强关键人员的能力很重要。这是确保供应链全面运转以及向最终用户提供优质药品和卫生用品的关键。
